Obsessive Compulsive Disorder OCD

No Laughing Matter

OCD is one of the better known types of anxiety disorders due to the preponderance of fictional media characters who seem to have it. Those who watch television and movies know of Monk or Jack Nicholson's character in As Good as it Gets. The characters show extreme aversions to touching objects and other people, a manifestation of their fear of becoming contaminated with germs or viruses or anything unknown. Around them are people who are understanding but bewildered. Unfortunately, most media characters seem to have this disorder for comical effect, downplaying its seriousness as it has a tendency to wreck people's lives in its most severe forms. Yet the truth is that OCD can be destructive rather than comical.

Perceptions of Risk

People who have OCD are most concerned about reducing their perceived risk of being harmed. This risk can be from what they understand about origins of infectious diseases, or toxicity from common household items. While it is true that there is some small inherent risk of harm in touching in any common object, people with OCD have an exaggerated perception of that risk. For example, while crossing the street always incurs the small risk of being hit by a passing car, it would be unnatural to avoid crossing all streets. This is because we are able to manage the risk. People with OCD may feel that the risk is not manageable, as they cannot see germs and viruses. Again, this is due to an inadvertent exaggeration of the risks.

Self-awareness of OCD

One of the most intriguing aspects of this disorder is that usually people are quite aware that their behavior is not within the norm. Even as the person is washing his or her hands, he or she is thinking something like "This is not quite normal, but if I just do it, I'll feel better." Therefore there is recognition and understanding of the problem. And because the perceived cost of satisfying these urges is so small, most people indulge their OCD tendencies by succumbing to them. Unfortunately, this usually means that there is no chance of eliminating or curing this disorder, because the people who have it are not making a concerted or conscious effort to do so. Left untreated, it can worsen and become more disruptive to every day life.

Origins of the Condition

The etiology (or origins of disease) of OCD are not clear. Medical science has advanced to a level where we understand the physical and chemical reactions that are happening, but the functionings of the brain is a different matter entirely as it involves the connections of trillions of neurons and how they bring forth emergent behavior such as consciousness and thought. What we do understand is some of the chemical reasons for mental disorders. These fall into two basic camps: serotonin and norepinephrine (or noradrenaline). Both are neurotransmitters (or perhaps a hormone in norepinephrine's case) that modulate behavior, mood, feelings etc. It has been found that in depressed people, or people with OCD, that these neurotransmitters are imbalanced in comparison to normal people. These findings were intially exciting as they suggested a chemical basis for thought and behavior, but progress has stalled for many decades as it has become increasingly clear that psychiatric and mind behaviors are not reducible to the concentrations of a few chemicals in the brain.

But at least the chemical basis of the various psychiatric disorders has given us one avenue of attack on the disease: that of SSRI and SNRIs. These two medications respectively upregulate the serotonin and norepinephrine in the synaptic junctions by blocking their clearance (or reuptake) into cell bodies. Their continued presence at synaptic junctions is whats responsible for normal behavior, or at least, for suppressing abnormal behavior.

Non-chemical Solutions

However, beyond chemistry there is another type of treatment which strives to use the mind itself to heal its own problems. This is the realm of psychotherapy, or psychiatry. The particular variant that has gained traction in recent times is the so-called "Cognitive Behavioral Therapy" (CBT). In CBT, the psychiatrist will question and analyze the patient, trying to determine the patterns of thinking that lead to a particular behavior. The treatment consists of interrupting that pattern of thinking with new patterns of thinking, hopefully leading to changes in behavior. However, there is a high failure rate for people who use this type of treatment for OCD, as the demands are taxing and many subjects drop out quickly.

Combinations

Nevertheless, it is hoped that a combination of chemistry and psychotherapy will be the best treatment for those as medical science progresses to find better therapies.